Conshohocken Dental Group, Llc

LBN: Conshohocken Dental Group, Llc
Conshohocken Dental Group, Llc is an health care organization with primary practice located at 200 W Ridge Pike Suite #129, Conshohocken PA 19428-3702. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice, Dental Providers / Periodontics. Dental Providers / General Practice is the primary health care specialty. Conshohocken Dental Group, Llc can be contacted via phone (610) 828-3535, or through Seo, Wansuk Seth via phone (610) 828-3535.

Contact Information

Primary practice address
200 W Ridge Pike Suite #129 Conshohocken PA 19428-3702
Phone: (610) 828-3535
Fax: (610) 828-3558
Website:
Map and Directions
Authorized official contact:
Name: Seo, Wansuk Seth Doctor of Dental Medicine (DMD)
Phone: (610) 828-3535

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DS038105 Pennsylvania
Dental Providers / General Practice 1223G0001X DS036612 Pennsylvania
Dental Providers / Periodontics 1223P0300X DS035484 Pennsylvania

Profile Details

NPI number 1619260155
LBN Legal business name Conshohocken Dental Group, Llc
DBA Doing business as
Authorized official Seo, Wansuk Seth Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date May 17th, 2011
Last updated May 17th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619260155 NPPES
Pennsylvania MEDICAID 102564482

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